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Biomedical subjects

B C Yankaskas

Publications and source records attributed to B C Yankaskas.

29 records · Page 2Linked to original sources

[Nuclear magnetic resonance in the diagnosis of multiple sclerosis. A critical review of the literature].

Nuclear magnetic resonance (NMR) has been proposed to be the best diagnostic test for multiple sclerosis (MS). We performed a critical analysis of 13 papers evaluating the use of NMR in MS. Out of an ideal 17 criteria for validation and reproducibility, a top of 11 (65%) was the maximum found. Foremost deficiencies were a lack of blind analysis and inadequate patient samples. Thus the claim that NMR is the diagnostic tool of choice in MS remains to be proven.

Humans↗

Roentgenographic classifications of hemophilic arthropathy. Comparison of three systems and correlation with clinical parameters.

In 105 knees, the roentgenographic classifications of hemophilic arthropathy of Arnold and Hilgartner, of Pettersson et al., and of a new system were compared. The amount of interobserver agreement (between two observers) was good for all three systems and, for all three, there was a good correlation between progressive severity of the lesion and decreasing function of the joint. The system of Pettersson et al. was better than that of Arnold and Hilgartner for grading severe arthropathy, but it was not better than the new, simplified system. The new system is a four-sign, 7-point classification, in contrast to the eight-sign, 13-point system of Pettersson et al.

Adolescent↗

Needle localization biopsy of occult lesions of the breast. Experience in 199 cases.

From January 1980 through June 1986, 199 percutaneous needle localizations for clinically occult breast lesions were performed at North Carolina Memorial Hospital. A retrospective analysis of the medical records, mammograms, operative notes, and pathology reports was undertaken to evaluate the success of this procedure. In our series, biopsy was prompted by abnormal calcifications in 27.1% of lesions, occult masses in 37.2%, and by a combination of occult masses and microcalcification in 35.7%. Overall, we had a yield of positive biopsies for cancer of 16.3%, with the yield improving from 12.3% in the earlier years of our study, to 18.7% in the latter years. Of the cancer cases detected, 89.7% were stage I. The localization procedure was successful in 95.9% of the cases. Analysis of our eight failures, along with a review of the literature, shows the major reasons for failure to be incomplete removal of areas with multiple calcifications, dislodgement of the needle, and problems resulting from lack of communication between the radiologist and surgeon. We conclude that the failure rate is low, the yield good, and needle localization a worthwhile procedure for localizing nonpalpable occult lesions.

Adult↗

Percutaneous small bore catheter drainage in the management of lung abscesses.

For patients with pyogenic lung abscesses who do not respond to medical therapy, thoracotomy with pulmonary resection is the widely-accepted treatment of choice. Six patients with lung abscess who failed to respond to conservative medical management were treated by percutaneous catheter drainage using small catheters (10 Fr or smaller). Five patients showed prompt clinical improvement and the sixth improved after a modification in antibiotic therapy. All patients recovered with radiographic resolution of the abscess and were well at followup periods from two months to two years. In such patients, percutaneous drainage with small catheters provides an excellent clinical result with minimal risk and trauma.

Adult↗

Delayed complications from fine-needle biopsies of solid masses of the abdomen.

A prospective study was conducted from 1977 through 1983, to determine the incidence of complications, particularly bleeding, after fine needle biopsy for suspected malignancy of the abdomen and pelvis. Hematocrits before and after the biopsy procedure, medical record follow-up, and review by a coagulation specialist were used to identify bleeders. We performed 395 biopsies on 360 patients. Thirteen percent of the patients had bothersome pain either during or after the biopsy. Hematocrit drops of 3% or more were found in 51 (12.7%) of the patients; nine were determined to be a direct result of the biopsy procedure. Our results and review of the literature suggest that there are complications, including delayed bleeding, yet few are life threatening. We caution, however, that adequate follow-up to identify bleeders is very important in patients having fine-needle biopsies of solid masses of the abdomen.

Abdominal Neoplasms↗

Screen-film mammography versus xeromammography in the detection of breast cancer.

There are two common methods of obtaining high-quality screening mammography: screen-film mammography (more simply, mammography) using a dedicated unit, and xeromammography. We studied the accuracy of the two techniques in detecting breast cancer by a retrospective study, analysing accuracy of interpretation in cases where both mammography and xeromammography were performed. Seventy-six patients were considered with 86 biopsies and mammograms resulting in detection of 32 cancers and 54 benign lesions. There was no difference in accuracy of interpretation between mammography and xeromammography. The sensitivities were: mammography 0.91, xeromammography 0.88. The specificities were: mammography 0.63, xeromammography 0.75. We conclude that both modalities are comparable in detecting cancer when optimal technique and experienced personnel are used.

Adult↗

Preemployment multiphasic screening in an urban manpower training program.

Preemployment health examinations have long occupied a central role in industrial medicine, providing company physicians with baseline health status and physical limitations for each employee. We evaluated a similar multiphasic screening examination in 662 young, minority applicants to an urban manpower training program. Resulting from this screening was a substantial number of patients with positive serology (1%), positive gonorrhea cultures (3%), excessive daily ethanol ingestion associated with liver enlargement (13%), decreased visual acuity (24%) and dental caries (23%). These findings are markedly different than those reported for preemployment screening in industry, suggesting the need for a specific health screening protocol for applicants to manpower training programs.

Adult↗

The radiologic diagnosis of pancreatic cancer. The effect of new imaging techniques.

The objective of this study was to evaluate how the introduction of radiologic studies affected the diagnostic workup for pancreatic cancer, from 1955 through 1979. For 961 patients diagnosed as having pancreatic cancer at three teaching hospitals, we reviewed medical records, autopsy reports, and death certificates for results from all radiologic studies, surgical and pathologic procedures, and for the final diagnosis. The number of radiologic studies per patient increased as new studies were introduced; 1.6 for 1955-1959, 3.5 for 1975-1979 (P less than 0.0001). Depending on the cutoff level chosen, the sensitivity of the overall radiologic diagnosis increased over time, 0.17-0.43 for 1955-1959, to 0.54-0.78 for 1975-1979; CT, US, and ERCP accounted for much of the increase. As newer radiologic studies are introduced, continued use of previously accepted studies should be carefully evaluated.

Adenocarcinoma↗

Image communications. What is needed and why.

Better communications are essential in the new medical environment. Methods to make more efficient the throughput in an existing department, foster confidence of patients, and improve the communications and efficiency of referring physicians are needed. The most difficult and thus the driving component of the new communications environment is image transmission. Concepts of picture archiving and communications systems, or PACS, arising from digital technology make possible unique and ubiquitous solutions to image communications. Better quality control and improved interpretation throughout the system, including the offices of referring physicians, will be possible. Radiologists are in a position to mold this new medical industry.

Computer Communication Networks↗